Prions, unprecedented among infectious pathogens, are composed of misfolded proteins. Mammalian prions tend to accumulate at high levels in the nervous system, causing fatal neurodegeneration. The most common form of human prion disorders is sporadic Creutzfeldt-Jakob disease (sCJD). The origin, spectrum, and structure of sCJD prions are unknown. The extraordinary phenotypic variability of the disease suggests the existence of many different conformers of pathogenic prion protein (PrPSc) coding for distinct CJD prion strains. Moreover, the co-existence of different proteolytic fragments of PrPSc in approximately 40% of sCJD brains has raised the intriguing possibility that conformationally distinct sCJD prions coexist in the same host. This, in turn, raises fundamental questions about the origin of sCJD prions, their evolution and hypothetical interference. The focus of this application is to decipher the conformation of PrPSc in sCJD patients and to elucidate the mechanism underlying the replication of human prions. Novel conformational methods in tandem with protein misfolding cyclic amplification (PMCA) and conformation-dependent immunoassay (CDI) will be used to identify the conformations and critical domains in human PrPSc that code for different strains of sCJD prions. The analysis of hydrogen/deuterium exchange in brain-derived PrPSc and PrPSc-like conformers amplified in vitro by PMCA, together with site-directed spin labeling strategy, should allow us to elucidate the strain- dependent conformational mechanism in the replication of natural sCJD prions. Furthermore, measurements of replication rates of sCJD prions with tandem CDI and PMCA combined with structural data should determine the specific conformational features of brain PrPSc that modulate replication rates and thus the progression rate of the disease. The ultimate goal of these studies is to advance our understanding of the molecular mechanisms governing the replication of human prion strains and the impact of PrPSc conformation upon the sCJD phenotype and transmissibility of the disease. This insight is critical for efforts to develop therapeutic strategies targeting sCJD PrPSc or its replication. PUBLIC HEALTH RELEVANCE: Sporadic Creutzfeldt-Jakob disease (sCJD) is a fatal, age-related human neurodegenerative disease caused by misfolded proteins, prions. The proposed studies of sCJD prions will deepen our understanding of the molecular basis of this neurodegenerative condition, and may provide a foundation for the development of novel therapeutic strategies that target human prions or their replication.